Pedro Brotons1, Hector D de Paz2, Diana Toledo3, Marta Villanova2, Pedro Plans4, Iolanda Jordan5, Angela Dominguez6, Mireia Jane7, Pere Godoy4, Carmen Muñoz-Almagro8. 1. Molecular Microbiology Department, University Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, 08950, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, 28029, Spain. 2. Molecular Microbiology Department, University Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, 08950, Spain. 3. CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, 28029, Spain. 4. CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, 28029, Spain; Public Health Agency of Catalonia, Barcelona, 08005, Spain. 5. CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, 28029, Spain; Pediatric Intensive Care Unit, Molecular Microbiology Department, University Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, 08950, Spain. 6. CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, 28029, Spain; Department of Public Health, University of Barcelona, Barcelona, 08005, Spain. 7. Public Health Agency of Catalonia, Barcelona, 08005, Spain. 8. Molecular Microbiology Department, University Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, 08950, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, 28029, Spain. Electronic address: cma@hsjdbcn.org.
Abstract
OBJECTIVE: To identify associations between nasopharyngeal Bordetella pertussis DNA load and clinical and epidemiological characteristics and evaluate DNA load prognostic value in pertussis severity. METHODS: Prospective observational multi-centre study including nasopharyngeal samples positive to pertussis DNA by real-time PCR collected from children and adult patients in more than 200 health centres of Catalonia (Spain) during 2012-2013. RESULTS: B. pertussis load was inversely correlated with age (rho = -0.32, p < 0.001), time to diagnosis (rho = -0.33, p < 0.001) and number of symptoms (rho = 0.13, p = 0.002). Median bacterial load was significantly higher in inpatients versus outpatients (4.91 vs. 2.55 log10 CFU/mL, p < 0.001), patients with complications versus those without (6.05 vs. 2.82 log10 CFU/mL, p < 0.001), disease incidence in summer and autumn versus spring and winter (3.50 vs. 2.21 log10 CFU/mL, p = 0.002), and unvaccinated-partially vaccinated patients versus vaccinated (4.20 vs. 2.76 log10 CFU/mL, p = 0.004). A logistic regression model including bacterial load and other candidate prognostic factors showed good prediction for hospital care (AUC = 0.94) although only age and unvaccinated status were found to be prognostic factors. CONCLUSIONS: We observed strong positive associations of nasopharyngeal bacterial load with severity outcomes of hospitalisation and occurrence of complications. Bacterial load and other independent variables contributed to an accurate prognostic model for hospitalisation.
OBJECTIVE: To identify associations between nasopharyngeal Bordetella pertussis DNA load and clinical and epidemiological characteristics and evaluate DNA load prognostic value in pertussis severity. METHODS: Prospective observational multi-centre study including nasopharyngeal samples positive to pertussis DNA by real-time PCR collected from children and adult patients in more than 200 health centres of Catalonia (Spain) during 2012-2013. RESULTS:B. pertussis load was inversely correlated with age (rho = -0.32, p < 0.001), time to diagnosis (rho = -0.33, p < 0.001) and number of symptoms (rho = 0.13, p = 0.002). Median bacterial load was significantly higher in inpatients versus outpatients (4.91 vs. 2.55 log10 CFU/mL, p < 0.001), patients with complications versus those without (6.05 vs. 2.82 log10 CFU/mL, p < 0.001), disease incidence in summer and autumn versus spring and winter (3.50 vs. 2.21 log10 CFU/mL, p = 0.002), and unvaccinated-partially vaccinated patients versus vaccinated (4.20 vs. 2.76 log10 CFU/mL, p = 0.004). A logistic regression model including bacterial load and other candidate prognostic factors showed good prediction for hospital care (AUC = 0.94) although only age and unvaccinated status were found to be prognostic factors. CONCLUSIONS: We observed strong positive associations of nasopharyngeal bacterial load with severity outcomes of hospitalisation and occurrence of complications. Bacterial load and other independent variables contributed to an accurate prognostic model for hospitalisation.
Authors: Amanda R Burnham-Marusich; Ryan K Olsen; Jacqueline Scarbrough; Alexander Kvam; Wei Yang; Lindsey Zimmerman; James J Dunn; Tod Merkel; Thomas R Kozel Journal: Sci Rep Date: 2020-09-14 Impact factor: 4.379